Covid-19 in patients with chronic lymphocytic leukemia: clinical outcome and B- and T-cell immunity during 13 months in consecutive patients

• DOI: 10.1038/s41375-021-01424-w
• Publication Date: 2021-09-25T13:02:34Z
• Authors: Lisa Blixt; Gordana Bogdanovic; Marcus Buggert; Yu Gao; Sophia Hober; Katie Healy; Hemming Johansson; Christian Kjellander; Sara Mravinacova; Sandra Muschiol; Peter Nilsson; Marzia Palma; Elisa Pin; C. I. Edvard Smith; Olga Stromberg; Margaret Sällberg...; Rula Zain; Lotta Hansson; Anders Österborg
• Keywords: Adult; Aged, 80 and over; Male; 0301 basic medicine; B-Lymphocytes; SARS-CoV-2; T-Lymphocytes; COVID-19; Middle Aged; Antibodies, Viral; Prognosis; Antibodies, Neutralizing; Combined Modality Therapy; Leukemia, Lymphocytic, Chronic, B-Cell; Article; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Aged; Follow-Up Studies

We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1-13 of the pandemic. Sixty patients (median age 71 y, range 43-97) were identified. Median CIRS was eight (4-20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1-6 vs 7-13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.